High Cortisol and Weight Loss

If you’re struggling with unexplained weight gain or can’t seem to lose body fat no matter how hard you try, you may be fighting against high stress hormones like cortisol.

In the 15 years that I’ve been practicing Functional Medicine, I’ve seen a lot of people with high cortisol - and most of them struggle to maintain a healthy body weight.

Interestingly, many of these folks have already been trying to lower cortisol directly - they’re taking ashwaganda and going to yoga class and working with a therapist to manage their stress - and that can be helpful.

But in order to truly leverage the power of cortisol in your favor, you need to really understand what cortisol is, what triggers your body to make it, and how it drives fat gain - especially fat in your midsection or belly area. Then you can treat it at the root cause.

Cortisol is a hormone from the glucocorticoid family that’s made and secreted by the adrenal glands. How much cortisol you make and circulate is determined largely by the hypothalamus, pituitary, adrenal axis or HPA Axis - in response to stress.

That stress could be mental or emotional - it could be a threat or a perceived threat - or it could be a physical stressor like inflammation in your digestive tract, high blood pressure, low ferritin levels, subclinical hypothyroidism, or other conditions. (common physical stressors)

People often forget about these physical stressors because we’ve been conditioned to think of stress as “all in our heads”, but the body treats all stressors the same - as a threat to survival.

And all stressors create real, biochemical changes in the body - including changes that cause fat gain or fat loss resistance.

This is why I recommend utilizing Functional strategies to address high cortisol instead of relying on lowering or avoiding stress triggers - because that’s not always possible or practical!

And it can also be dismissive and belittling to suggest that stress management is the solution when your external stressors are unavoidable - perhaps you’ve had this experience. I know I have, and it’s not helpful or fun.

I’ll get to my top 3 surprising strategies for losing fat by lowering cortisol in a few minutes, but first we should talk about how cortisol messes with body composition in the first place.

When cortisol is balanced and following a healthy circadian rhythm, it helps support the immune system, heal from injuries, encourage healthy sleep at night and energy during the day, and sustain the body’s processes for survival in the short-term - all of this means that cortisol isn’t the bad guy.

But when it’s too high or too low - when it’s dysregulated and desensitized to the signals the brain is sending it - or when it’s being made in excess by rogue fat cells, the benefits of cortisol become detriments.

Next I’ll break down the main ways that high cortisol causes you to gain body fat or struggle to lose weight so that we can make sure the strategies we use to treat the problem are working at the root cause.

The first way that high cortisol impacts body fat is by causing cravings and messing with your appetite. It does this by altering the function of leptin, one of nature’s appetite suppressants.

When leptin is functioning properly, it tells your brain to stop eating when you’ve had enough.

It’s the “put down your fork” hormone that helps regulate energy storage and expenditure - and it’s made by your fat cells.

It works over the long term by moving through the bloodstream to the brain, telling it to decrease hunger signals and increase energy utilization.

But more leptin isn’t necessarily better.

In fact, when your brain is bombarded with leptin signals from your fat cells, over time it becomes desensitized to the satiety signal.

The receptors for leptin in the brain become numb or less responsive to the increased leptin levels, which means you don’t feel full even when you are.

It’s like you have a broken hunger thermostat, where even though the temperature is turned all the way down, the furnace keeps kicking out heat - in this case, it can cause intense cravings especially for carbs and sugars, addictive eating patterns, and increased fat gain or trouble maintaining a healthy body composition.

This is called Leptin resistance, and it is a vicious cycle that many people find themselves trapped in.

Because not only does leptin resistance trigger cravings and hunger signals, it also changes your metabolism so you burn less stored energy or fuel.

This means the food you eat is more likely to be stored as fat…which then releases MORE leptin, which increases Leptin resistance and leads to more hunger and cravings. High cortisol triggers leptin resistance by increasing fat storage and exacerbates it by directly reducing the brain’s sensitivity to leptin.

The second way that high cortisol impacts body fat is by promoting a process in the liver called gluconeogenesis.

If you break down the word you may be able to guess what this means. Gluco, or glucose, neo or new, genesis or formation - cortisol causes new glucose or sugar to be made and released into circulation by the liver, elevating blood sugar levels.

This can be a good thing if you’re encountering a threat because it provides more fuel for your cells. But if that threat is chronic - like enduring a toxic workplace or raising children - and you’re not able to burn off that extra glucose by running away from the stressor, it becomes a bad thing, especially for your waistline.

When blood glucose is elevated but not utilized, it is eventually stored as fat - especially in the midsection.

Some of that belly fat may be distributed around the viscera, underneath the abdominal muscles, packed around your intestines, lymph nodes, blood vessels, and other organs in the abdominal cavity.

This is called visceral adipose tissue, and it significantly increases your risk for developing diseases like type 2 diabetes and cardiovascular disease.

Visceral fat also makes it’s own cytokines, which are chemical messengers that tell the surrounding tissue to activate the immune system and upregulate chronic inflammation - which, in itself can cause weight gain or fat loss resistance.

The third way that high cortisol impacts body fat is by counteracting insulin - a hormone that tells your cells to take in and burn up glucose to make energy.

Without proper insulin signaling, you may be left with chronically elevated blood sugar even if you’re eating a healthy, low-carb, low-sugar diet - all because of too much cortisol!

This is one of the most frustrating and demoralizing ways that high cortisol causes fat gain or fat loss resistance - even if you’re doing all the right things from a dietary standpoint, cortisol can sabotage your efforts.

And if this wasn’t bad enough, the fact that you have elevated blood glucose is itself a physical stress trigger, which means more cortisol production. Not to mention that elevations in insulin will, over time, lead to diseases like metabolic syndrome, type 2 diabetes, and heart disease.

I know, I know - that’s a lot of bad news. But I do have some good news for you, too. I’m going to share my top 3 surprising strategies for both lowering cortisol and dropping some fat - all of which are evidence-based and Functional-Medicine approved.

The best part about these strategies is that they don’t just lower cortisol levels - they do so by treating the root cause of high cortisol in the first place.

This is really important, because cortisol isn’t the bad guy - the regulation of cortisol levels is what we need to target. And that must include reducing or resolving the physical stress triggers that are causing the brain and HPA axis to make too much cortisol in order to achieve sustainable results.

To make it easy for you, I’ve compiled these strategies into a free checklist that you can download - just click on the image below!

Really quick note - there are literally hundreds of ways to balance cortisol and promote healthy fat loss, so if you’ve already tried the following strategies or you’re looking for more options, check out the Exclusive Video Library within my YouTube membership.

All of my long-form webinars, tutorials, and deep dives live inside the membership - and when you click that "Join" button you’ll get access to all of it for a few bucks a month.

I’ll be adding to the library every month with more members-only videos on topics like thyroid health, gut health, lowering inflammation, boosting energy, sleep health, and more - I know it sounds crazy to put all my trainings in one place but I really really want you to have access to this game-changing information and resources, and this is a great way to make it more accessible.

To sign up, simply click the "Join" button HERE.

Ok - now that we have all that housekeeping out of the way, let’s talk Functional strategies.

My top strategy for lowering cortisol and dropping body fat is to balance your blood sugar.

The reason this is my favorite strategy is because it addresses high cortisol both directly and indirectly, so you get exponential benefit.

And you’ve got lots of strategies at your disposal to promote better blood sugar - here are a few that I’ve found particularly helpful: eat something with fiber, protein, and/or healthy fats every 4 hours during the day.

These foods digest more slowly and evenly, which helps avoid glucose spikes and crashes, which lowers cortisol’s compensatory spikes and crashes. Avoiding simple sugars and naked carbs is another good strategy.

What do I mean by naked carbs?

I mean foods that contain only simple sugars or carbs without a healthy amount of fiber, protein, or fat.

A few examples of naked carbs are white rice, peeled white potatoes, and white bread. Simple sugars are often found in beverages like fancy coffee drinks, sports drinks, soda, and fruit juices.

You may also consider adding a targeted, blood-sugar balancing nutraceutical like Berberine to your daily routine.

Berberine, a natural compound found in plants, is sometimes called “nature’s ozempic” for it’s ability to improve insulin resistance, balance blood sugar, and help folks lose fat.

According to a 2012 meta-analysis of 14 different studies including more than 1,000 people, berberine was able to help with blood sugar control as much as the common diabetes medication metformin - and with far fewer side effects.

Because leptin resistance is so closely linked with insulin resistance and metabolic syndrome, Berberine helps calm cravings and improve metabolism, too.

You can find my favorite Berberine supplement in the checklist - and if you order it through my Fullscript dispensary you’ll get a significant discount.

My second best strategy for lowering cortisol and dropping body fat is to improve the brain’s ability to regulate the HPA Axis.

Think about it, if your brain is hyped up on adrenaline, stuck in fight-or-flight, or exhausted from chronic stress, it’s not going to send helpful signals to your adrenal glands, which can result in everything from anxiety to constipation to sleep problems and of course fat gain.

Thankfully, your brain is easily influenced by your habits, your thought patterns, and how you breathe and move. One of the pathways that your brain uses to regulate cortisol is the vagus nerve, also known as cranial nerve 10.

When you tone this nerve, or sensitize it, you help the brain communicate with the adrenal glands and better regulate cortisol.

The vagus also directly regulates satiety or the feeling of being full, inflammation, and even Glucagon-like peptide 1 or GLP-1, the target of popular weight loss drugs like Ozempic.

Toning the vagus nerve can be as simple as gargling with water for 60 seconds every night, humming a tune while you’re in the shower, or practicing deep belly breathing for 15 minutes per day.

These habits aren’t just calming for your emotions, they directly stimulate the vagus nerve and rebalance the HPA Axis, lowering elevated cortisol and helping you lose fat.

The science is really strong here, but you need to be consistent and persistent to get the most benefit from vagal nerve toning.

I also love to feed the brain specific micronutrients that help reduce inflammation, like neurologic-specific omega fatty acids, and that boost calming neurotransmitters like GABA - I’ll put some suggestions in the checklist for you to have a peek at, along with the Berberine.

My third best strategy for lower cortisol and dropping body fat is to improve the sensitivity of your insulin receptors.

This one sort of goes along with balancing blood sugar, but it’s more specific.

For most folks who struggle with high cortisol and too much body fat, the problem isn’t that they can’t make enough insulin to trigger glucose uptake into the cell, but that the receptors that insulin has to bind to are desensitized.

In fact, 1 in three Americans are insulin resistant.

You have many, many tools at your disposal for re-sensitizing those insulin receptors including eating more fiber from fruits and vegetables and getting enough exercise.

And before you roll your eyes at me about exercise, let me remind you that even if that exercise is not helping you lose weight directly, it does directly improve insulin sensitivity and build muscle, which boosts metabolism.

One specific compound that has promising evidence for reducing insulin resistance is resveratrol, a polyphenol found in dark berries, red grapes, and peanuts.

A meta-analysis of 11 studies and 338 subjects found that resveratrol consumption significantly reduced markers of fasting glucose, insulin, hemoglobin A1c, and insulin resistance.

Resveratrol is also a strong anti-oxidant and is very anti-inflammatory, which helps reduce cortisol levels, too. It can be tough to get therapeutic levels of resveratrol in your diet, so unless you really, really love blueberries, it can be helpful to supplement. I’ll put a good option for you in the checklist, too.

I hope this information helps you have a better understanding of how high cortisol can prevent weight loss, and gives you some strategies to restore balance and drop some body fat.